Adequacy of energy and protein intake among hospitalized patients on therapeutic diet in government hospitals

Abstract

Purpose The provision of meals has long been regarded as an essential part of treatment of hospitalized patients complementing medical procedures and nursing management. Today, despite changes in the health-care landscape, which focused on improving the quality and efficiency of hospital care, malnutrition among inpatient was still a common worldwide concern. Design/methodology/approach This was a multi-centre, randomized study conducted in 21 study sites comprising 21 state and specialist government hospitals under the Ministry of Health, Malaysia. The sample size for this study was calculated with purposive sampling method, followed by proportionate sampling to determine the random sample size of each of the study sites. The total sample size required for this study was 2,759 subjects. A validated data collection form was used in the study. Findings Only 32.2 % and 37.6 % of subjects achieved adequate energy and protein intake, respectively, during their admission to medical ward. The study result showed that the overall mean energy and protein intake was 794.6 ± 487.8 kcal and 35.2 ± 24.3 g, respectively. The estimated energy (p = 0.001) and protein (p = 0.001) intake of all study sites was significantly lower compared to the adequacy value. Research limitations/implications The adequacy intake in this study was only carried out in medical wards, thus reproducible result among other wards in different study sites could not be confirmed. Besides, this study assumed that the portion eaten by subjects during lunch and dinner was the same, and therefore, either one was recorded together with breakfast and either lunch or dinner to represent a subject’s daily intake. Originality/value This was the first nationwide study to report the adequacy of energy and protein intake of patients receiving therapeutic diets in the government hospital setting in Malaysia.

Hospital Food Waste: Contributing Factors of Waste Generation and Strategy for Waste Minimization

“…The investigation of gender-based disparities in food waste is deemed significant due to variations in nutritional needs between males and females. Kong et al (2020) confirmed that male participants in their research exhibited significantly greater average calorie and protein consumption than their female counterparts.…”

“…The food delivery system is a significant aspect that impacts patients' dietary intake. A centralized delivery system guarantees that each patient receives a fully assembled order with a predetermined portion size and quality control measures from a central location (Kong et al, 2020). On the other hand, a decentralized delivery service system only dispatches large quantities of hot or cold prepared foods to ward kitchens all over the hospital (Kong et al, 2020).…”

“…A centralized delivery system guarantees that each patient receives a fully assembled order with a predetermined portion size and quality control measures from a central location (Kong et al, 2020). On the other hand, a decentralized delivery service system only dispatches large quantities of hot or cold prepared foods to ward kitchens all over the hospital (Kong et al, 2020). A measure that has been the subject of numerous research is transitioning from a centrally plated meal system to a bulk meal distribution system (Dias-Ferreira et al, 2015).…”

“…Some critiques of this system are related to the amount of remaining food in the trolley, which somewhat undermines the benefits of minimizing plate waste (Dias-Ferreira et al, 2015). This is because the distribution of meals is carried out by ward assistants, increasing the likelihood of mistakes (Kong et al, 2020). Therefore, it is imperative to exercise caution when determining the quantity of food to be cooked to prevent waste transmission along the food supply chain (Dias-Ferreira et al, 2015).…”

“…Healthcare practitioners, including dietitians, may play a crucial role in enhancing the palatability of meals and ensuring adherence to patient nutritional intake. Food Service Dietitians fulfill a vital role in the production line by ensuring the delivery of proportionate and sufficient dietary requirements and in meal preparation and distribution (Kong et al, 2020). Moreover, they possess a favorable position to impact environmental modifications throughout the food system, particularly within hospital food services (Collins & Porter, 2023).…”